高度近视三种角膜屈光手术术后远期角膜后表面高度的变化  

The long term changes of height of posterior corneal surface in high myopia after three kinds of corneal refractive surgery

作　　者：高芬 张婉婷 周青霞 穆红梅 Gao Fen;Zhang Wanting;Zhou Qingxia;Mu Hongmei(Department of Ophthalmology,Kaifeng Municipal Central Hospital,Kaifeng Eye Hospital,Kaifeng 475000,China)

机构地区：[1]开封市中心医院眼科开封市眼病医院,475000

出　　处：《中华眼外伤职业眼病杂志》2021年第10期756-761,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的比较高度近视行SMILE、LASEK及LASIK术后远期角膜后表面高度的变化。方法回顾性对照研究。对开封市眼病医院2012年2月至2013年12月行角膜屈光手术的高度近视者103例(103眼)的临床资料进行分析。根据手术方式分成3组:SMILE组,37例(37眼);LASEK组,31例(31眼);LASIK组,35例(35眼)。记录术后3年时角膜最薄点、角膜顶点角膜后表面高度的变化量,对3组结果进行对比分析。结果术后3年,3组角膜最薄点后表面高度变化量分别为:(-3.65±3.12)μm、(-4.59±3.07)μm、(-1.76±3.56)μm,组间差异有统计学意义(F=4.802,P=0.017);角膜顶点后表面高度变化量为:(-2.82±2.17)μm、(-4.01±2.59)μm、(-0.95±3.07)μm,组间差异有统计学意义(F=50.36,P<0.001);光学区直径4 mm 0°位处后表面高度变化量为:(1.92±2.39)μm、(-1.70±4.01)μm、(-0.21±3.29)μm,组间差异有统计学意义(F=16.98,P<0.001)。结论三种手术方式术后角膜后表面高度均下降,且均稳定,LASEK术后角膜后表面高度下降量最大,稳定性最好,SMILE术后角膜稳定性优于LASIK。Objective To compare the long term changes of the posterior corneal surface height after SMILE,LASIK and LASEK in high myopia.Methods A retrospective case control study was conducted.The clinical data of 103 eyes of 103 high myopic patients underwent corneal refractive surgery from Feb.2012 to Dec.2013 in Kaifeng Ophthalmic Hospital were analyzed.According to different operation methods,all cases were divided into 3 groups:SMILE group with 37 eyes of 37 cases;LASEK group with 31 eyes of 31 cases and LASIK group with 35 eyes of 35 cases.The changes of the posterior surface height of the cornea at the thinnest point and corneal vertex at 3 years after surgery were recorded.The results among the three groups were compared and analyzed.Results At 3 years after operation,the changes of the posterior surface height of the thinnest cornea in the three groups were(-3.65±3.12)μm,(-4.59±3.07)μm and(-1.76±3.56)μm,respectively.The differences were statistically significant(F=4.802,P=0.017).The changes of posterior surface height of corneal vertex in the three groups were(-2.82±2.17)μm,(-4.01±2.59)μm and(-0.95±3.07)μm.The differences were statistically significant(F=50.36,P<0.001).The changes of surface height at 0°of optical region diameter of 4 mm were(1.92±2.39)μm,(-1.70±4.01)μm and(-0.21±3.29)μm.The differences were statistically significant among three groups(F=16.98,P<0.001).Conclusion The posterior surface height of the cornea decrease at 3 years after SMILE,LASIK and LASEK,and all of them are stable.LASEK has the largest decrease in posterior surface height and the best stability,while SMILE is better than LASIK in corneal stability.

关 键 词：高度 后表面 角膜 近视 高度 飞秒激光小切口透镜取出术(SMILE) 准分子激光原位角膜磨镶术(LASIK) 准分子激光角膜上皮瓣下磨镶术(LASEK) 

分 类 号：R779.63[医药卫生—眼科]